by Michael Kern
Being at rest
In craniosacral work a practitioner can never quite know what really needs to happen for the patient, but the intelligence within the patient’s own system does. The practitioner has to go along for the ride,27 simply following and trusting the ordering principle of the Breath of Life and how it wants to work. Therefore, finding a neutral place from which to practice is of critical importance if the patient’s self-healing forces are to be supported without interference.
Finding a practitioner neutral involves developing a quality of attention that is able to be at rest.
Paradoxically, being at rest requires practice, as distractions and stimuli are usually all around. The spectre of violence grabs our attention on the nightly news, our emotional life becomes played out through soap operas, and battles rage to get us to buy more products that promise the answer for happiness. However, the real problem with this bombardment is that we often lose sight of ourselves in the process. Our attention becomes habitually taken away from us, so we become out of touch. We lose our own sense of being. We then often crave even more stimulation just to be able to feel anything at all.
Accessing a practitioner neutral means developing an attention that is neither being drawn away nor preoccupied with ourselves. It involves finding a place where our attention is neither coming nor going, but resting at a neutral point somewhere in between. The ability to find this place of stillness to listen from is another foundation of clear craniosacral palpation.
Beginner’s mind
Being neutral also means listening with a sense of enquiry and wonder, as well as having no judgement or expectation of what may be found. It implies being with another person from a place of unknowing. This may feel quite scary at first, as we let go of what we think we know and move into a deeper listening. This kind of attention is called “beginner’s mind” in Zen Buddhism.28 It involves seeing things as if for the first time. As Confucius is quoted, “He who departs from innocence, what does he come to?” Children have beginner’s mind quite naturally, but as adults we are usually encouraged to lose it.
When I was about three years old, I had an imaginary friend whose name was “Gog-gog.” One day I told my parents about how Gog-gog looked after me. He would appear at special times and take me on wonderful adventures. Sometimes we would fly out of my bedroom window and circle around the garden and up over the neighbor’s houses to look at the view. When I told my parents of this adventure, they laughed and I felt deeply hurt. I learned that Gog-gog was an object of ridicule and it was better not to speak about him. I put him out of my mind until many years later when, flicking through a book on Celtic mythology, I saw that the names of two ancient spirits who took care of small children in our area were called Gog and Magog. There are even two old trees in the east of England named after these great protectors of children.
Because most of us are told to put away such childish perceptions, from an early age we learn to accept only those thoughts and feelings, such as those of our parents and teachers, that comply to the prevalent world view. We may consequently live our lives within the conformity of a narrow but accepted range of perception. We may become intellectually smart but lose the ability to trust in our instinctual “felt sense.” However, this kind of intellectual knowing does not encompass the realm of our inner wisdom and is not enough to reconnect us with our source of health. In order to truly appreciate our deeper intelligence, we need to make a perceptual shift.
THE ART OF PALPATION
The wonder of touch is the wonder of human kindness.29
DIANNE M. CONNELLY
Language of the body
Anatomy is the language of the body. A good knowledge of anatomy enables the practitioner to understand the messages that the body communicates. For example, fluid, bone, membrane and nerve tissue each have their language and convey their state of health in particular ways. Each of these speak through the patterns and qualities of their primary respiratory motion.
A clear diagnosis is the springboard for effective treatment. Therefore, the practitioner needs to be able to recognize how the body has become patterned by experiences, and to appreciate the forces that organize its motion. When treating, the practitioner’s hands may need to determine the specific pattern that the body is holding before it is ready to resolve its inertia. If a clear diagnosis is not established, then treatment can become a hit or miss affair.
Finger sensitivity
Palpation can be defined as sensing with the hands. This is a process in which information is transmitted to the brain by sensory nerve endings in the fingers called proprioceptors. These nerve endings relay information about motion and position. The fingers contain the highest amount of nerve proprioceptors of any area of the body, making them acutely sensitive to even the most minute of impulses.
Figure 6.3, below, depicts a homunculus. This is a diagrammatic representation of the proportional amount of the brain that is used to receive impulses from different regions of the body. The larger the area of the body in the drawing, the more brain-space is devoted to it. As indicated, a significant proportion of the brain is dedicated to the hands, making them probably the most sensitive parts of the body. They are still far more receptive and responsive than any machine invented, distinguishing them as ideal instruments for feeling subtle movements and other phenomena in the body.
Figure 6.3: Sensory homunculus—indicating the proportion of the brain used to process sensory information (illustration credit 6.3)
According to Dr. Harold Magoun, “The human hand has been called the greatest single diagnostic instrument known to man. Marvellous as the advances of objective science may be, nothing takes the place of a searching analysis of the tissues with a well-trained palpatory sense, to determine not only the condition present but also the best procedure to modify or remedy it.”30 Interestingly, some years ago an extremely sensitive instrument for measuring magnetic fields was invented, called the Superconducting Quantum Interference Device (SQUID). For the first time it became possible to measure the magnetic fields that surround the human body, and it was found that the hands have by far the highest field strength of any part of the body.31 In other studies at Massachusetts Institute of Technology, it was found that the hands can even detect the movement of light in the absence of any visual stimulus—providing a further indication of the range of our palpatory capabilities.32
Palpation of health
The hands in craniosacral work are used as perceptual antennae.33 The fingers learn “how to feel, how to think and how to see” the patterns, qualities and nuances of primary respiration.34 The subtle rhythms of the Breath of Life are essentially expressions of wellness, carrying our original matrix of health into the body. Therefore, palpation of the primary respiratory system gives the practitioner direct access into the underlying condition of health and any restrictions to its expression. It also enables the practitioner to assess the body’s available resources, which can be utilized in treatment.
Awareness with subtle senses
In addition to the faculty of touch, the physiological processes of a patient can sometimes make themselves known through a variety of other sensory impressions. For example it may also be possible for a practitioner to “see” a disturbance in the form of visual images. The way this information is received may be similar to how sonar waves permeate the ocean.35 When an area of contraction or condensation is met, there is an echo back that can be registered by the sensory awareness of the practitioner.
It is not infrequent that the faculty of smell can give the practitioner valuable clinical knowledge. There have been many occasions when I have smelled anaesthetic drugs emanating from a patient who was accessing tissue memories of surgical trauma. Some practitioners report auditory perceptions, in which impressions about their patient are heard. It may be possible to hear a subtle buzz being given off from someone who is in a state of nervous excitation or activation, even though they are not speaking. It seems that all of our se
nses can be refined to pick up tones that are outside of what is considered to be our normal range of perception. Moreover, instinctual and intuitive impressions can provide access to more esoteric or archetypal realms of experience.
A few years ago a man in his early twenties came for treatment of a frozen shoulder. As soon as he walked in the room I had an awkward feeling about him, but didn’t know why. While I was taking his case history there was something in his manner that made me uncomfortable. This continued as I began the process of palpation. On his second visit, it seemed that my awkward feeling was explained when he disclosed that he had been involved in terrorist activities. It became clear that he was still full of bitterness, justifying the use of violence for his cause. I started to sense that his frozen shoulder was nature’s way of preventing him from engaging in more violence. If this was the case, the last thing I wanted to do was to help free his shoulder. I had the feeling that, in the circumstances, there was probably nothing I could do for him. Nevertheless, I asked him to consider the messages that his own body was giving him and suggested he let nature take its course for a while. Who knows where this kind of information comes from? Perhaps his case was just out of my league.
Tuning in
The start of every treatment session is marked by a time of tuning in, when the practitioner listens through the hands to the qualities of primary respiration. In this way, the practitioner is essentially orienting to the health within the patient, rather than just focusing on what’s wrong. Tuning in is usually done from the cranium, the sacrum or the feet, but can be practiced from anywhere in the body. Within the unified field of function of the body, attention may be placed on the rhythmic motion of specific structures such as a cranial bone or a membrane, the motility of the central nervous system, or the motility and glide of connective tissues. The longitudinal fluctuation of cerebrospinal fluid can also be palpated to determine how this important carrier of potency is functioning.
Any disorder is indicated by restrictions or distortions in the symmetry, quality, rate or amplitude of primary respiratory motion. This may manifest as a loss of motility and mobility in the tissues, a low potency or drive in the fluids, and swirls or condensations of fluid and potency. We will now consider the significance of some of these phenomena.
Fluid drive
The quality of motion expressed by the longitudinal fluctuation of fluid is largely determined by the degree of available potency it expresses. The strength or force of this motion is referred to as the system’s fluid drive. If the underlying potency becomes diminished or restricted in its expression, then the fluid drive will be weaker. This may be felt as a sense of dullness, congestion or lack of spark in the expression of longitudinal fluctuation. A weak fluid drive is indicative of deficient resources available for healing. Low potency affects the very foundations upon which our health is built and is often found in states of chronic illness or exhaustion. Therapeutically, the priority in these situations is to build the availability of these vital healing reserves.
Amplitude
If the quality of fluid drive is reduced, or if inertial fulcra create restrictions, the degree of motion expressed by tissues can be diminished. For example, a cranial bone may be able to express primary respiration in all the normal directions, but only moves within a very small range. This range is called its amplitude. If tissues are unable to breathe fully with the Breath of Life, they are unable to receive the full benefit of their essential ordering principle.
Some practitioners also place an emphasis on measuring the rate at which tissues express the cranial rhythmic impulse. This rate can vary according to circumstances, and so may provide an indication of physiological changes taking place. However, my own experience is that measuring the rate provides less valuable clinical information. The rate just gives a number (such as so many cycles per minute) but evaluating the patterns and qualities of primary respiratory motion points to how the system has become organized and the availability of potency, which are important for both diagnosis and cure.
Palpation of inertia
If the body is holding patterns of inertia, tissues, fluids and potency will not be able to express their natural primary respiration.
For example, when palpating at the level of the mid-tide, inertial patterns will be perceived as particular distortions or shapes within a unified field of motion, organized around inertial fulcra. These inertial patterns can produce a loss of tissue mobility, resistances, adhesions, compressions, pulls or asymmetries, and condensations and lateral fluctuations of fluid and potency. Midline structures may not be able to express their natural flexion and extension, and paired structures may be inhibited from expressing their external and internal rotation. All of these indicate some form of stressful experience that has become held in the body, producing a conditioned pattern of primary respiration away from its natural fulcra and midline axis.
It is always important for the practitioner to ascertain the site of the inertial fulcrum that is at the heart of a particular pattern. This is done by noticing the still or stuck place around which the pattern has become organized. This place is like the eye of the hurricane, containing the whole potency of the storm.36 It is within the inertial fulcrum that the key is found, which can unlock the forces maintaining the pattern.
Tissues, fluids and potency
Inertial fulcra will be perceived in different ways according to whether the practitioner is orienting to tissues, fluids or potency. When tuning in to tissue movement, an inertial fulcrum can be palpated as a loss of tissue motility and/or mobility. When tuning in to fluid movement, an inertial fulcrum may be sensed as a condensation of fluid and the site around which lateral fluctuations occur (see the next section). When tuning in to potency, an inertial fulcrum may be perceived as a site of densification or darkness, around which swirls or fluctuations of potency may occur.
Lateral fluctuation
If the longitudinal fluctuation of fluid and potency meets the resistance provided by an inertial fulcrum, various eccentric patterns of motion are produced. This resistance is like a rock on a smooth, sandy beach. Instead of the water being able to gently glide up the beach, all kinds of swirling motions are created as it hits the rock. These lateral fluctuations of fluid and potency can be palpated in the body in the form of eddies, currents, whirlpools or congestion.
When the practitioner notices any movement of fluid and potency that is not expressed as a natural longitudinal fluctuation, it is indicative of inertia and resistance in the system. If there is no resistance present, the longitudinal tidal motion of fluid and potency is smooth and even, and carries a good quality of drive. Noticing the places around which lateral fluctuations are produced can provide the practitioner with a clear sense of the location of organizing inertial fulcra (see “Dialogue with fluids”).
Shutdown
If the resources of a person’s primary respiratory system become overwhelmed, his or her cranial rhythmic impulse (and sometimes the mid-tide) can temporarily stop. This is called a shutdown. It is a self-protective physiological reaction, marked by an abrupt and sudden cessation of rhythmic motion. Dr. John Upledger has named this kind of phenomenon a “significance detector” because it indicates that a significant experience for the patient has been accessed.37 It reveals the presence of some kind of physical and/or emotional distress held in the system, often restimulated when the body is in the same position that it was at the time of receiving a trauma. In my experience shutdowns actually indicate that, for the time being, the patient is unable to access sufficient resources to deal with the experience that has been evoked. When things get too much, our physiological response is to close down.
It is worth noting that a shutdown differs from another phenomenon called a stillpoint which occurs in states of deep physiological rest (see Chapter 7). While both a shutdown and a stillpoint involve a cessation of rhythmic motion, they have very different qualities. During a stillpoint there is a smooth and gentle settling of t
he rhythm as it relaxes into stillness. In a shutdown, motion comes to a screeching halt.38
“CONVERSATION” SKILLS
To work with living mechanisms in a living body, we need living palpatory skills.39
DR. ROLLIN BECKER D.O.
Asking questions
Craniosacral work is essentially a practice of listening to and facilitating expressions of primary respiration. However, it is also possible to talk to the body by engaging it in a “conversation” to clarify its story. The practitioner can make enquiries through his hands, and then listen to the responses. In this way, the body can talk back, letting the practitioner know of its priorities. The perceptual focus of the practitioner, and how he meets a patient’s system, determine exactly what can be palpated. As Dr. John Upledger remarks, “What you ‘know’ seems related to which questions you have in mind during examination.”40 The physiology of the patient can be engaged in particular conversations by the introduction of specific enquiries brought into the practitioner’s hands during palpation.
Dialogue with tissues
It is possible to sense if a particular bone prefers to express inhalation/flexion or exhalation/extension. At the start of an inhalation phase of primary respiration, a subtle invitation for the bone to move into flexion can be offered through the practitioner’s hands. How the bone takes up that invitation is then noted. To evaluate extension, a subtle invitation can be offered at the start of an exhalation phase. If the bone moves into one phase of motion more easily than another, or if there is some other asymmetry, it indicates the presence of inertia. If the bone moves into inhalation/flexion, but doesn’t move so easily into exhalation/extension, then it is holding what is called a “flexion pattern.” Inertial patterns are named after their preferred direction of motion. Therefore, a flexion pattern describes tissues that are held in flexion and so cannot fully express extension.